NPIMap

Organization Active NPI

East Metro Family Practice, P.a.

  • Family Medicine Physician
  • Saint Paul, MN
National Provider Identifier
1104044692
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
1417 Issued in MN
Legal business name
EAST METRO FAMILY PRACTICE, P.A.
Practice address
911 Maryland Ave E
Saint Paul, MN 55106-2647
Phone
(651) 776-2719
Fax
(651) 771-3978
NPI assigned
Apr 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Paul Berrisford
Title
Ceo
Phone
(651) 772-1572

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 1417 MN Primary

Addresses

Primary practice location

911 Maryland Ave E
Saint Paul, MN 55106-2647

Mailing address

2025 Sloan PL
Suite 35
Saint Paul, MN 55117-2007
Phone (651) 772-2077

Other names 1

  • East Metro - Maryland Doing business as

National Provider Directory

National Provider Directory
Tax ID family
East Metro8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104044692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 SLOAN PL",
            "address_2": "SUITE 35",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551172007",
            "telephone_number": "651-772-2077",
            "fax_number": "651-772-1889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 MARYLAND AVE E",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551062647",
            "telephone_number": "651-776-2719",
            "fax_number": "651-771-3978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST METRO FAMILY PRACTICE, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BERRISFORD",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "651-772-1572"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "1417",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "East Metro - Maryland",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.